Provider Demographics
NPI:1134897614
Name:GILL, DONNA BENNETT (LPC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:BENNETT
Last Name:GILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 SHELBOURNE CIR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5209
Mailing Address - Country:US
Mailing Address - Phone:214-535-9171
Mailing Address - Fax:
Practice Address - Street 1:5080 SPECTRUM DR STE 1000E
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6444
Practice Address - Country:US
Practice Address - Phone:214-960-3632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15380101YA0400X
TX83618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)